In 2002, Magda Mostafa, a then-PhD student at Cairo University, was given an exciting project: to design Egypt's first educational centre for autism. The young architect set herself down to the task of researching into autism design, certain she'd soon find guidelines and accessibility codes to direct her through the process (after all, about one in every 88 children is estimated to fall into the autism spectrum).

But, as Mostafa told me, "I had a rude awakening; there was virtually nothing."

So she started setting up studies to gather the evidence she'd need to come up with her own guidelines. And she was breaking ground: a study she completed in 2008 was "among the first autism design studies to be prospective not retrospective, have a control group, and measure quantifiable factors in a systematic way."

Since those uncertain beginnings, Mostafa has positioned herself as one of the world's pre-eminent researchers in autism design. Her latest work, summarized in "An Architecture for Autism," the journal IJAR's most downloaded article in 2012, outlines Mostafa's latest accomplishment: the Autism ASPECTSS™ Design Index, both a matrix to help guide design as well as an assessment tool "to score the autism-appropriateness of a built environment" post-occupancy. In the following interview, we discuss the Index, the potential of evidence-based design for architecture, and what it's like to break ground (and try get funding) in a country where "black-outs, security threats, water shortages and unbelievable traffic" are everyday occurrences.

After showing two groups of schoolteachers a videotape of an eight-year-old boy, psychologists John Santrock and Russel Tracy found that the teachers’ judgment of the child ultimately depended on whether they had been told the child came from a divorced home or an intact home. The child was rated as less well-adjusted if the teachers thought he came from a home where the parents were divorced. This finding might seem inconsequential to the field of architecture, but for a profession that often relies on observational studies to evaluate a design’s effect on its users I argue that Santrock and Tracy’s study is one among many architects need to pay attention to. An observational study*, like post-occupancy surveys, is a common method architects use to evaluate a design’s effect on its users. If done well observational studies can provide a wealth of valuable and reliable information. They do, however, have their pitfalls, most notably controlling for cognitive and selection biases. At the risk of limiting readership, I will illustrate these challenges by reviewing a specific observational study dealing with autism design. Although specific, the following example wrestles with the same difficulties that other observational studies in architecture wrestle with.

April is Autism Awareness Month, and ArchDaily would like to draw your attention to the architectural coverage we have done on the topic. Autism Spectrum Disorders (ASD) are developmental disorders that affect 1 in 88 children. The spectrum is large and diverse. It ranges from individuals who can be socially withdrawn, have extreme learning difficulties and little to no communication to individuals who can be highly intelligent but socially awkward. Each individual, however, exhibits, to varying degrees, impairments in social interaction and communication, and restricted and repetitive behavior. ArchDaily’s coverage looks at the various approaches architects have taken when designing for individuals with autism. We hope to get your feedback on the articles and your help in spreading autism awareness. Lighting Spatial Considerations The Neuro-Typical ApproachArchitecture for Autism: Architects moving in the right direction More Able Not Less Disabled

How do we know that sulfuric acid does not cure scurvy? Is it our wonderful intuitive sense about sulfuric acid’s properties? That can’t be it. Vitriol (sulfuric acid) used to be the Royal College of Physicians’ favored choice. The British Admiralty preferred vinegar. Still others favored a variety of remedies including the seemingly ridiculous notion of fresh fruit. This mess wasn’t sorted out until a young Scottish naval surgeon named James Lind did something revolutionary. In 1747 Lind conducted world’s first controlled clinical trial. Fresh fruit won, sulfuric acid and vinegar lost. Similarly, there are various untested claims about which architectural interventions are beneficial for individuals with autism (see: here, here, here, and here). For the most part, these claims are mired in anecdote and conjecture. This makes it impossible to decipher which ones are sulfuric acid, vinegar or fresh fruit. Fortunately there are a few architects that have started to embrace the Lind spirit. This is the most important and necessary step architects need to take. If architects do not try to verify their claims through fair tests then they run the risk of undermining the public’s trust or worse, unintentionally doing harm to a vulnerable population.

Imagine meeting with a client and writing down only their limitations and dislikes. Now, return to your office and base your design on that criterion alone. How can any architect create an inspiring and meaningful design out of that? Yet, this is how many architects design for people with Autism Spectrum Disorders (ASD). The focus is on what individuals with autism cannot do rather than what they can. Such a negative approach seems misguided and unnecessary. Architects should make people more able not less disabled. It is a subtle distinction, but an important one.

Similar to a mainstream school setting, Celebrate the Children, a school for children with autism, lines its hallways with colorful banners, photographs, and student artwork. Parents concerned with some of their children’s hypersensitivities often ask Monica Osgood, the school’s director, if there is too much stimulation. Monica responds that her students need to learn in ‘real’ world settings if they will ever have a chance to use their acquired skills outside of the classroom. This logic for replicating ‘neuro-typical’ environments, argues directly against the sensory sensitive approach, and, with reasons worth exploring. Individuals with autism often have very poor generalization skills. Therefore proponents of ‘neuro-typical’ simulated environments claim that sensory sensitive environments actually cause less, not more, universal access and integration into the larger population. Whether or not there is any truth to this claim is unknown. There are strong arguments for and against the ‘neuro-typical’ approach, but there are no definitive studies comparing the sensory sensitive approach to the ‘neuro-typical’ approach.

Last week we looked at the different sensory sensitive approaches to lighting design for autism. We saw how contradictory recommendations have arisen from a lack of reliable research specific to autism and lighting. Conflicting recommendations are not limited to lighting. They can be found among nearly every aspect of autism design, including but not limited to acoustics, tactile and olfactory design. Today we will look at spatial considerations before we turn to the “neuro-typical” approach that contradicts the sensory sensitive approach altogether.

What do we know about designing for individuals with autism? Those concerned with sensory issues are split on some issues. Some say we should limit daylight and exterior views, keep ceiling heights low and spatial volumes small, use restrained details, subdued colors, and reduce acoustical levels. Others advocate for high ceiling heights, large spatial volumes, and high levels of daylight with plenty of views to the outside. Still others disagree with catering to sensory needs altogether. They point out that individuals with autism struggle generalizing skills, and designing sensory heavens can do more harm than good. Thus they argue for autism classrooms, schools, and homes that mimic all the colors, sounds, lighting, and spatial volumes of “neuro-typical” environments. So who is right?